Women are more prone to ACL tears and runner's knee, but these expert-approved moves can help reduce your risk.

You don't have to be a high-intensity athlete to suffer a knee injury. Swinging a golf club or turning too quickly on the stairs can cause the anterior cruciate ligament (ACL) to stretch beyond its normal range, resulting in a tear. And that's just traumatic injury. Even in the pursuit of fitness, we may unintentionally damage the joint; patellofemoral pain syndrome (PFPS), sometimes called runner's knee, is a common overuse injury. The risk is especially high for women: We're two to eight times more likely than men to damage our ACLs and as much as two times more likely to suffer from runner's knee. 

Researchers believe that the reasons women are more prone to knee injuries are mostly structural. Women's bodies typically have wider hips, higher rates of knock-knees, less space for the ACL and weaker ligaments, plus there's a tendency to use thigh muscles more than hamstrings, explains Dr. David Robinson, primary-care sports medicine physician at the David Braley Sport Medicine & Rehabilitation Centre at McMaster University in Hamilton. These anatomical factors all stress the ACL, effectively stacking the joint deck against us. But there might be a hormonal element, too. Fluctuating sex hormones may affect how loose our ligaments are at different points in our cycles, and for some women, that may mean decreased knee stability. Read on for tips on how to reduce your risk for the three most common types of knee injury.

ACL tears
These injuries tend to happen when you stop or change direction suddenly, or land incorrectly, often during an intense sport. The ACL keeps your shinbone from sliding out in front of the thighbone, so when it stretches, comes loose or tears, you'll feel pain and have swelling and reduced range of motion. Depending on the severity, you may need surgery. 

Reduce your risk: "Training can ensure the correct knee-over-feet-and-under-hip position when landing," says Dr. Robinson. So if you're a big fan of activities like soccer or Frisbee, make sure you don't skip your warm-up. We like 11+, an injury prevention program developed by medical experts working with FIFA.

PFPS (a.k.a. runner's knee)
Pain in the front of the knee—including the soft tissue—that makes climbing stairs or kneeling down uncomfortable could be PFPS. The cause is often over-exercising, although inactive women can get runner's knee, too. Other culprits include problems with hip-knee-ankle alignment or doing too many squats and other knee-bending activities. If it's severe enough, you'll need to reduce activity until the pain dissipates.

Reduce your risk: A patellar tracking sleeve fitted by a bracing specialist, or custom-fit orthotics—or both!—can help. "But if you do knee-strengthening exercises, you won't need a sleeve," says Dr. Robinson.

Meniscus tears
You may hear a pop or feel pain a few days after you tear your meniscus, which is the cartilage that acts as a shock absorber between your thighs and shins. Tears often happen when you're squatting or twisting your knees, such as when you're tackled during sports, swinging your club during golf or crouching in the garden. Aging can also weaken your meniscus; sometimes, getting out of a chair awkwardly can be all it takes. Small tears may heal with rest, but severe tears require surgery.

Reduce your risk: Dr. Robinson says that exercises like the ones in our routine (below), warming up before activities and wearing shoes with good traction to prevent slips can all help minimize the risk of injury.

Before you start!
Be mindful of form. Make sure your bent knee is lined up directly over your second toe. "This helps protect the joint," says physiotherapist Monica Maly. And make sure you don't allow your knee to rotate inward or outward as you move.

Don't go in cold. "Warming up before exercise can help prevent knee injuries," says Maly. Warming up can be as simple as brisk walking or cycling for 20 minutes—but save gentle stretching for your cooldown.

Your knee-saver exercise routine
These yoga-inspired exercises from Monica Maly, physiotherapist and associate professor at McMaster University's School of Rehabilitation Sciences in Hamilton, target key muscle groups that help protect your knee joints and boost your strength, coordination, balance and flexibility. Aim to do the routine three times a week, one set per session.

Bridge

Illustration by Kagan McLeod

Aim: Stronger gluteals and hamstrings and increased hip flexibility.
- Lie down on your back with knees bent and feet flat on the floor, shoulder-width apart. Lay your palms flat on the floor.
- Raise your hips as high as you can, squeezing your gluteal muscles. Hold for 10 seconds.
- Repeat six times.
Form check: Your knees should point straight to the ceiling before you begin raising your hips.

Warrior lunge

Illustration by Kagan McLeod 

Aim: Increased hip flexibility and improved balance.
- Stand with feet together and shoulders back and relaxed.
- Raise your arms out to your sides, parallel to the floor and palms facing down. Step your feet about three feet apart.
- Rotate from the right hip joint to position your right foot at a 90-degree angle. Align your right heel with your left heel.
- Exhale and bend your right knee to a 90-degree angle. Hold for 10 seconds. - Repeat three times on each side.
Form check: Don't bend your knee past your toes.

Squat

Illustration by Kagan McLeod

Aim: Stronger quadriceps, hamstrings and gluteals.
- Stand with feet together and shoulders back and relaxed.
- Bend your knees, pulling your shoulder blades together, and aim for a 75-degree angle at the knee joint and a 90-degree angle at the hip. Hold for 10 seconds.
- Repeat six times.
Form check: Make sure your trunk is over your thighs. From the front, the hip, knee and ankle of each leg should form a straight line.

Tree pose

Illustration by Kagan McLeod 

Aim: Stronger hip abductors, ankle muscles and dorsiflexors for improved balance.
- Stand with feet together and shoulders back and relaxed.
- Bring your palms together in front of your chest.
- Bend one knee and place the sole of that foot on the inner calf or inner thigh of the standing leg (but never on the knee). Hold for 10 seconds.
- Repeat three times on each side.
Form check: Keep your pelvis level and facing forward; stare at an object straight ahead to help keep your balance.